Mohamed Kharief*

Gastroenterology Registrar, University Hospital Waterford, Waterford, Ireland

*Corresponding Author: Mohamed Kharief, Gastroenterology Registrar, University Hospital Waterford, Waterford, Ireland.

Received: July 01, 2025; Published:July 14, 2025

Abstract

Bouveret syndrome is an uncommon complication of gallstone disease that can lead to gastric outlet obstruction and, more rarely, gastrointestinal bleeding. We present the case of an elderly male with a known history of cholelithiasis who was admitted with coffee-ground vomiting. Investigations revealed a large gallstone impacted in the duodenum and the presence of a cholecysto-duodenal fistula with associated bleeding. Endoscopic evaluation identified fresh blood at the site of impaction, and subsequent imaging confirmed the diagnosis. The patient underwent surgical removal of the stone with a favourable recovery. This case highlights an unusual bleeding presentation of Bouveret syndrome, underscoring the need for high clinical vigilance and prompt multidisciplinary management in such rare scenarios.

Bouveret syndrome is a rare complication of gallstone disease, usually presenting with gastric outlet obstruction.

Upper gastrointestinal bleeding is a rare and atypical manifestation, often leading to delayed diagnosis.

The Rigler triad (pneumobilia, small bowel obstruction, and ectopic gallstone) is suggestive but not always seen on plain films.

Endoscopic stone removal may be attempted, but surgical intervention is often required, particularly for large impacted stones.

Multidisciplinary assessment and individualized treatment planning are essential, especially in elderly or frail patients.

Keywords: Bouveret Syndrome; GI Bleeding; Manifesting

References

1. Bouveret L. “Sténose du pylore adhérente à une vésicule contenant des calculs”.
   La Revue de medicine 16 (1896): 1-16.
2. Caldwell KM., et al. “Bouveret syndrome: current management strategies”. Clinical and Experimental Gastroenterology 11 (2018): 69-75.
3. Singh G., et al. “A case report and review of the literature of Bouveret syndrome”. Annals of the Royal College of Surgeons of England 1 (2020): e15-e19.
4. Byard RW. “Cholecystoduodenal fistula: an unusual finding at autopsy”. Spanish Journal of Legal Medicine 2 (2024): 82-85.
5. Bhandari TR., et al. “Bouveret’s syndrome: an old A modern multimodality approach (endoscopic and robotic surgical) of gastric outlet obstruction: report of two cases”. International Journal of Surgery Case Reports 114 (2024): 109134.
6. Baharith H and Khan “Bouveret Syndrome: when there are no options”. Canadian Journal of Gastroenterology and Hepatology 29.1 (2015): 17-18.

Citation

Citation: Mohamed Kharief. “Bouveret Syndrome Manifesting as Upper GI Bleeding: A Rare Case Report".Acta Scientific Gastrointestinal Disorders 8.7 (2025): 05-10.

Copyright

Copyright: © 2025 Mohamed Kharief. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.